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Apply least privilege at the server, Dokploy, application, database, integration, and network layers. Treat logs, backups, screenshots, DICOM studies, and interface messages as potentially sensitive clinical data.

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Production security baseline

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Host and Dokploy

  • Named SSH accounts with keys; restrict SSH to approved VPN or IP ranges.
  • HTTPS for Dokploy and every user-facing service.
  • Strong authentication and least-privilege project access in Dokploy.
  • Timely security patching and a documented emergency update process.
  • Public firewall limited to approved SSH, HTTP, and HTTPS traffic.
  • Host disk encryption where supported and encrypted off-site backups.

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Application

  • APP_ENV=production, APP_DEBUG=false, and secure session cookies.
  • Preserve APP_KEY in the recovery vault.
  • Public registration remains disabled.
  • Named accounts, administrator 2FA, periodic access reviews, and immediate offboarding.
  • Role assignments based on job function and segregation of duties.
  • Least-privilege Sanctum tokens with owners, abilities, expiry/review, and rotation records.

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Data and integrations

  • Never expose PostgreSQL to the public network.
  • Keep OIE administration behind VPN, tunnel, allow-list, or identity-aware access.
  • Restrict analyzer, MLLP, ASTM, DICOM, and DICOMweb paths to approved systems.
  • Enable production-grade Orthanc authentication and access controls before storing real studies.
  • Keep mock services stopped, unrouted, and blocked in production.
  • Sanitize channel exports, logs, screenshots, messages, and support bundles.

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Secret handling

Rotate a secret immediately after exposure. Review dependent services, cached configuration, logs, exports, and backups to determine whether the old value remains usable.

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Incident severity

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Incident response

1

Declare and assign command

Record time, reporter, affected environment, known impact, incident commander, clinical lead, technical lead, communications owner, and evidence custodian.
2

Protect patients and contain

Stop unsafe clinical or integration processing, activate downtime procedures, isolate affected accounts/services/networks, and revoke exposed tokens without destroying evidence.
3

Preserve evidence

Retain relevant deployment identifiers, logs, alerts, access events, hashes, timestamps, and system state. Limit PHI access and record who handled evidence.
4

Eradicate and recover

Correct the cause, rotate secrets, rebuild from trusted artifacts when needed, restore through the tested runbook, and reconcile all downtime and external-system records.
5

Validate and reopen

Obtain technical, security, and clinical approval after health, data-integrity, access, workflow, backup, and monitoring checks pass.
6

Review

Document root cause, timeline, impact, decisions, corrective controls, owners, and due dates. Update the relevant runbook without including sensitive incident details.
Do not delete logs, rotate evidence away, rebuild the server, or restore over the affected environment until the incident commander and evidence owner approve the action.